# Safety and Efficacy of Two Different Concentrations of Ketamine and Propofol Combinations in Cataract Surgery: A Double-blind Randomized Clinical Trial: Efficacy of Two Different Concentrations of Ketofol in Cataract Surgery

## TL;DR

This study compares two ketamine-propofol mixtures for cataract surgery sedation, finding the 4:1 ratio safer and more satisfying for patients and surgeons.

## Contribution

The study introduces a novel comparison of two ketamine-propofol ratios for sedation in cataract surgery, identifying the 4:1 ratio as superior.

## Key findings

- The 4:1 ketamine-propofol ratio resulted in higher patient and surgeon satisfaction compared to the 2:1 ratio.
- The 4:1 ratio showed better cardiovascular stability with less significant changes in SPO2 and heart rate.
- Lower ketamine doses (4:1 ratio) provided safe and effective sedation for cataract surgery.

## Abstract

Due to the importance of appropriate sedation and immobility of the patient
in cataract surgery, this study was performed to compare the safety and
efficacy of a combination of ketamine and propofol (ketofol) in two
different ratios.

This double-blind, randomized clinical trial was carried out on patients who
underwent cataract surgery in Feyz Hospital, Isfahan, Iran. Patients were
randomly divided into group I (n=30, ketamine/propofol 2:1 ratio) and group
II (n=30, ketamine/propofol 4:1 ratio). The quality of sedation (using
Ramsay sedation scale [RSS]), cardiovascular parameters such as systolic
blood pressure (SBP), diastolic blood pressure (DBP), arterial blood
pressure, SPO2, and heart rate, as well as patient and surgeon satisfaction,
were evaluated in both groups.

The SPO2 and heart rate were significantly lower and higher in group I than
in group II during various surgery times, respectively (P=0.0001 for both
comparisons). In terms of patient and surgeon satisfaction, it was found
that no patient was dissatisfied with the sedation status in group II, while
four patients (13.3%) in group I were dissatisfied (P=0.005). However, RSS,
SBP, and DBP were significantly different between the two groups (P0.05 for
all comparisons).

It seems that the use of lower ketamine doses in combination with propofol
(4:1) is a safe and preferable option to provide sedation in cataract
surgery.